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LAND USE PERMIT APPLICATION — Burnett County, WI a <br />Z <br />Applicant Complete All Sections Below This Line <br />Permit Types and Fees: (Check appropriate box/boxes) <br />Dwelling/Principal Building - Single Family <br />$300 <br />Addition to Dwelling/Principal Building - Single Family $200 <br />Dwelling/Principal Building - Multi -Family <br />$300 <br />Structural Alteration to Dwelling/Principal Buildings $200 <br />Commercial/Industrial Building <br />$300 <br />Addition to Commercial/Industrial Building $200 <br />Accessory Structure(Non-Bunkho use)' <br />$150 <br />Addition to Accessory Structure $150 <br />Bunkhouse <br />$250 <br />Structural Alteration to Accessory Structure $150 <br />Accessory Structure -Commercial (C1 & 11) <br />$200 <br />Addition to Accessory Structure -Commercial (C1 & 11) $200 <br />Deck/Stairs/Patio/Retaining Wall/Sidewalk/Driveway & <br />Campground Structures <br />$125 <br />Gazebo (WI Stat 59.692(lv)) $350 <br />Filling/Grading $150 <br />Camping Unit (Six Months Per Year) <br />$100 <br />Boathouse $500 <br />Permit Extension (Valid for one year - Only 1 Allowed) <br />$100 <br />*NOTE: After -the -fact (when no permit is obtained prior to construction) is up to three times the normal fee. <br />*Communication Towers & Signs require a different application form, see corresponding application and fees. <br />*Items not listed above will be treated as accessory structures, such as: pergolas, landscaping, etc. <br />Property Owner's Name: llAW I i <br />Property Owner's Mailing Address <br />Property Site Address: IVO <br />audre, k - Var be <br />6 (-emo R ve- 5 t P."I M N <br />Contact's Telephone Number: 76 3 -- 30 ? — IY 31 Y <br />Contact's Email: 015, Vt-xrbcr j ® a mw+ 1. w," <br />Legal Description of Property: Sa.l� 014 TAJ iq—B� Is Lor 3 C S m V 6 P t 63 t(b©N Lof 4) <br />Section #: o!y Town #:_N Range #: /5- W Town of: I—eLf o/%Gtr <br />*A ttach additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page. * 1 <br />Tax ID # (1-5 digit number; found on tax statement): 6011) <br />Proposed Use of Structure/ ddition: 5 o rc;,e— S ��� DrtaLbl e_ S ted l49 X /G <br />Anticipated Start Date: Home/Cabin; Commercial Business; Bedroom; Deck etc.) <br />CDn <br />Building Contractor: Sewer Installer: <br />AREA BELOW THIS LINE RESERVED FOR ZONING STAFF COMMENTS/CONDITIONS ONLY <br />THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br />Aa 0 <br />?-,o�--3-.al9 <br />Date of staff site visit: L 9 `I �- Initials of site visit staff: S a <br />PERMI G OFFICIAL: DATE: <br />Y <br />Page 1 of 3 <br />Burnett County, WI Land Use Application — Rev 03/2017 <br />